Ruwaa’s daily struggle
Ruwaa Muntasir Abdul Karim, a 14-year-old girl from northern Gaza, sits quietly in a dialysis chair at al-Shifa Hospital. Her life depends on these sessions, but with fewer hours of treatment and limited machines, her strength wanes. Her father watches closely, worried by the steady decline in her health and the long wait for a critical solution. Every dialysis session is vital for Ruwaa, who used to be active and playful before her health began to deteriorate. Now, she endures the treatment in silence, as her body relies on the machines to keep her alive.
Before the war, Ruwaa walked and played. Now, each dialysis session is a battle for survival. Her father, Muntasir, says that any interruption in her treatment causes severe fatigue and shortness of breath. The constant pressure of war and the collapse of Gaza’s healthcare system have made even basic care like dialysis a luxury few can access. For families like his, the promise of a kidney transplant remains distant, stuck in bureaucratic limbo. The situation for Ruwaa is dire, and every moment wasted could be her last.
A collapsing dialysis system
At Al-Aqsa Hospital in central Gaza, only 26 out of 51 dialysis machines are operational. The Palestinian Ministry of Health reports that half of all dialysis machines in Gaza are now out of service. A shortage of sodium bicarbonate, necessary for operating the machines, has made the situation worse. This critical shortage has forced healthcare workers to ration care, leaving many patients without the essential treatment they need.
The number of hospitals capable of treating kidney failure has dropped from seven to four. The Noura al-Kaabi Dialysis Centre, once a key facility, was destroyed during the war. This has forced hospitals to cut both the number and length of dialysis sessions, increasing the risk of medical complications for patients. With fewer machines and a lack of supplies, the burden on those that remain is immense. Patients are being pushed to their limits, and the consequences are dire.
According to the Palestinian Centre for Human Rights, more than 470 kidney failure patients have died in Gaza since the war began. The total number of such patients dropped from 1,200 to about 700 due to missed sessions and a lack of essential medications. This alarming rate of death highlights the severity of the crisis. The loss of life is not just a result of disease but of the deliberate collapse of healthcare in the region.
Waiting for a transplant
Ruwaa’s father says everything is ready for a kidney transplant. Her mother is the donor, and the medical tests match. But Israel must approve all trips out of Gaza, and Ruwaa’s application has been pending for six months. The war has rendered local facilities incapable of performing such procedures, leaving families in limbo. The delay in approval is a matter of life and death for Ruwaa. Without a transplant, her condition will continue to worsen, and the hope for a future may slip away.
Ruwaa’s weight has dropped from 65kg to 35kg. The number of dialysis sessions she receives each week has fallen from three to two. Her father’s constant vigilance at the medical monitor reflects the fragile state of her health and the high stakes of what remains. Every session is a reminder of the life she once had and the future she may not get to experience.
The broader crisis extends beyond dialysis. Over 43,000 people in Gaza now live with life-changing injuries, including amputations and permanent disabilities, according to the World Health Organization. The war has crippled the healthcare system, leaving many without the prosthetics or care they need to survive. The damage is not just physical but systemic, with the entire infrastructure of healthcare in the region on the brink of collapse.